Which medications in the drug class Keratolytic Agents are used in the treatment of Molluscum Contagiosum?

Updated: Aug 09, 2018
  • Author: Ashish C Bhatia, MD, FAAD, FACMS; Chief Editor: Dirk M Elston, MD  more...
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Answer

Keratolytic Agents

These agents inhibit cell growth and destroy infected cells. They are applied directly to lesions. To decrease discomfort, treat a small number of lesions at each visit.

Salicylic acid (Compound W, Freezone, Wart-Off)

Salicylic acid produces desquamation and inflammation. Various liquid products that contain 17% salicylic acid as the caustic agent or as part of a mix of caustic agents used to treat molluscum contagiosum and warts are available. Most of these products include an adhesive such as collodion or a clear nail-polishlike material, which dries within seconds of application. This helps to concentrate the caustic agent on the lesion and minimize spread to the surrounding skin.

Tretinoin topical (Retin-A, Avita, Tretin-X)

Tretinoin is available in various bases and concentrations (0.025%, 0.05%, 0.1% cream; 0.01%, 0.025%, 0.1% gel; 0.05% solution). Applied to a region of skin with scattered lesions, tretinoin may produce eczema and increase the number of lesions through autoinoculation. However, a small amount of tretinoin may be applied to individual lesions with good effect.

Cantharidin

Cantharidin is a strong vesicant. It has not been approved by the FDA for the treatment of any condition but has been safely and effectively used by dermatologists for years. In the American Academy of Dermatology treatment guidelines for warts, it is listed as the second-line therapy following liquid nitrogen. However, because cantharidin has never been approved by the FDA for use in humans, it is no longer marketed in the United States.

Cantharidin crystals and diluent can be purchased in the United States, and numerous dermatologists continue to use it. Cantharidin solution for the treatment of warts and molluscum is available in Canada and many other countries. The effectiveness results from the exfoliation of the lesion as a consequence of cantharidin's vesicant action. The lytic action does not go below the basement membrane of epidermal cells. As a result, unless the area becomes secondarily traumatized or infected, no scarring from topical application occurs.


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